Couples who have a child with cancer are faced with multiple and pervasive stressors from the time of diagnosis through survivorship. They must deal with their own emotional distress as well as that of their children, and juggle their usual responsibilities with those imposed by the child's illness. Having a child with cancer strains couples' relationships and can lead to relationship distress. Moreover, the way in which parents respond as a couple to the child's cancer may ultimately impact the adjustment of each parent, the child, and the family system. Despite the importance of couple functioning in the context of childhood cancer, to date there have been no studies of couple-based interventions for parents of children with cancer. The proposed study evaluates the feasibility and preliminary efficacy of a newly developed, cognitive-behavioral couple-based intervention. Participants will be 30 couples whose children are being treated for a first diagnosis of cancer. Couples will be randomly assigned with a 2:1 allocation to the Couple-Based Relationship Enhancement intervention or an Education/Support control condition, both of which will consist of six, one-hour telephone-based sessions. The Couple-Based Relationship Enhancement intervention will provide couples with training in well-validated relationship skills to communicate effectively and problem-solve about issues related to caring for their child with cancer, maintaining their own couple's relationship, and supporting each other as individuals. The primary aims of the study involve determining whether the Couple-Based Relationship Enhancement is feasible and acceptable to couples, and whether it will lead to improvements in their relationship functioning, individual functioning for both partners, and parental functioning compared to the attention control condition. The impact on child and family functioning will also be assessed. Assessments conducted before and after treatment will include couples' reports of their relationship functioning, individual psychological well-being, parental functioning, child well-being, and overall family functioning, along with audio recorded cancer-related conversations that will be rated on dimensions of partner support and communication skills. Findings from this study have the potential to result in the creation of an effective intervention that will lead to improved couple and family adjustment to childhood cancer. If successful, we will propose a subsequent, larger RCT that includes long-term follow-up. PUBLIC HEALTH RELEVANCE: Couples who have a child with cancer are faced with multiple and pervasive stressors from the time of diagnosis through survivorship. Despite the central role that couples play in families' adjustment to childhood cancer, to date there has been no studies of couple- based interventions for pediatric cancer. This study might significantly improve our understanding of how to assist couples in important roles that they fulfill as a couple, individual, and parents, as they adapt to having a child with cancer.